STROBE Statement—checklist of items that should be included in reports of observational studies

Item Page
No
Recommendation No

Title and abstract 1 (a) Indicate the study’s design with a commonly used term in the title or the
abstract

(b) Provide in the abstract an informative and balanced summary of what

was done and what was found

Introduction

Background/rationale 2 Explain the scientific background and rationale for the investigation being
reported

Objectives 3 State specific objectives, including any prespecified hypotheses

Methods

Study design 4 Present key elements of study design early in the paper

Setting 5 Describe the setting, locations, and relevant dates, including periods of
recruitment, exposure, follow-up, and data collection

Participants 6 (a) Cohort study—Give the eligibility criteria, and the sources and methods
of selection of participants. Describe methods of follow-up

Case-control study—Give the eligibility criteria, and the sources and

methods of case ascertainment and control selection. Give the rationale for
the choice of cases and controls

Cross-sectional study—Give the eligibility criteria, and the sources and

methods of selection of participants

(b) Cohort study—For matched studies, give matching criteria and number
of exposed and unexposed

Case-control study—For matched studies, give matching criteria and the

number of controls per case

Variables 7 Clearly define all outcomes, exposures, predictors, potential confounders,

and effect modifiers. Give diagnostic criteria, if applicable

Data sources/ 8* For each variable of interest, give sources of data and details of methods of
measurement assessment (measurement). Describe comparability of assessment methods if
there is more than one group

Bias 9 Describe any efforts to address potential sources of bias

Study size 10 Explain how the study size was arrived at

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 Quantitative variables 11 Explain how quantitative variables were handled in the analyses. If
applicable, describe which groupings were chosen and why

Statistical methods 12 (a) Describe all statistical methods, including those used to control for
confounding

(b) Describe any methods used to examine subgroups and interactions

(c) Explain how missing data were addressed

(d) Cohort study—If applicable, explain how loss to follow-up was

addressed

Case-control study—If applicable, explain how matching of cases and

controls was addressed

Cross-sectional study—If applicable, describe analytical methods taking

account of sampling strategy

(e) Describe any sensitivity analyses

Continued on next page

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Results

Participants 13 (a) Report numbers of individuals at each stage of study—eg numbers potentially
* eligible, examined for eligibility, confirmed eligible, included in the study, completing
follow-up, and analysed

(b) Give reasons for non-participation at each stage

(c) Consider use of a flow diagram

Descriptive 14 (a) Give characteristics of study participants (eg demographic, clinical, social) and
data * information on exposures and potential confounders

(b) Indicate number of participants with missing data for each variable of interest

(c) Cohort study—Summarise follow-up time (eg, average and total amount)

Outcome data 15 Cohort study—Report numbers of outcome events or summary measures over time
*
Case-control study—Report numbers in each exposure category, or summary
measures of exposure

Cross-sectional study—Report numbers of outcome events or summary measures

Main results 16 (a) Give unadjusted estimates and, if applicable, confounder-adjusted estimates and
their precision (eg, 95% confidence interval). Make clear which confounders were
adjusted for and why they were included

(b) Report category boundaries when continuous variables were categorized

(c) If relevant, consider translating estimates of relative risk into absolute risk for a
meaningful time period

Other analyses 17 Report other analyses done—eg analyses of subgroups and interactions, and
sensitivity analyses

Discussion

Key results 18 Summarise key results with reference to study objectives

Limitations 19 Discuss limitations of the study, taking into account sources of potential bias or
imprecision. Discuss both direction and magnitude of any potential bias

Interpretation 20 Give a cautious overall interpretation of results considering objectives, limitations,

multiplicity of analyses, results from similar studies, and other relevant evidence

Generalisability 21 Discuss the generalisability (external validity) of the study results

Other information

Funding 22 Give the source of funding and the role of the funders for the present study and, if
applicable, for the original study on which the present article is based

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*Give information separately for cases and controls in case-control studies and, if applicable, for exposed and
unexposed groups in cohort and cross-sectional studies.

Note: An Explanation and Elaboration article discusses each checklist item and gives methodological background and
published examples of transparent reporting. The STROBE checklist is best used in conjunction with this article (freely
available on the Web sites of PLoS Medicine at http://www.plosmedicine.org/, Annals of Internal Medicine at
http://www.annals.org/, and Epidemiology at http://www.epidem.com/). Information on the STROBE Initiative is
available at www.strobe-statement.org.